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Biomedical subjects

M Neumann

Publications and source records attributed to M Neumann.

At least 181 records · Page 10Linked to original sources
PubMed1993

The selling of mental health services: some ethical reflections.

Since the introduction of public mental health services in Israel, the main principle of our work has been to provide equal and free of charge health services to all patients. We were proud of our ability to provide optimal treatment to all patients in all our facilities, regardless of cost or status of insurance. During the last decade, the cost of providing good quality public health services, including mental health services, has constantly increased, and the system has reached a state of financial distress resulting in insufficiency and inability to perform properly. In order to maintain the level of mental health services, the health authorities started planning a system of payment for various mental health services which, until now, were supplied free of charge. This change of policy and attitude towards the population in need poses severe ethical and practical questions and problems. It is questionable that the amount of income ensuing from the sale of mental health services and whether a relatively small financial profit justify possible injury of the population in need of these services, especially the sicker and weaker members of it. This article raises some ethical doubts involved in charging money for psychiatric services that are given to this special group of the mentally ill, and claims that the feasibility of selling services in this area of public health should be reinvestigated.

Cost Control↗
PubMed1993

The role of iodine-123-Tyr-3-octreotide scintigraphy in the staging of small-cell lung cancer.

The purpose of this study is to investigate the role of 123I-Tyr-3-octreotide scintigraphy in staging small-cell lung cancer (SCLC), its efficacy for the discrimination of limited and extensive disease stages and its regional sensitivity for different metastatic locations. Twenty patients with histologically confirmed SCLC and 50 radiologically staged tumors sites were investigated by an imaging protocol including dynamic (0-30 min p.i.), static (30 min, 90 min, 4 hr, 24 hr p.i.) and SPECT (90 min p.i.) studies. The primary tumor site was visualized in 84%, whereas the best delineation was noted in early planar (15-30 min p.i.) and SPECT studies, due to a rapidly decreasing tumor-to-background ratio. Lymph node metastases were seen in 73%, but SPECT was needed for anatomical localization. All three adrenal metastases could be identified in sequential planar images. One clinically unsuspected brain metastasis was seen, whereas a second clinically overt metastasis was not visualized. The global and regional sensitivity for liver and bone metastases was unsatisfactory. In summary, 78% (7/9) of the patients with extensive disease were correctly identified by scintigraphy alone. We conclude that 123I-Tyr-3-octreotide scintigraphy is a substantial tool in the staging work-up of SCLC if it is performed initially to allow fast identification of patients with extensive disease stages and save additional radiological or invasive examinations. Yet, 123I-Tyr-3-octreotide scintigraphy cannot substitute liver sonography or conventional bone scanning in patients who have no scintigraphic evidence of distant tumor spread.

Carcinoma, Small Cell↗
PubMed1993

[Bronchial hyperreactivity to distilled water].

For an epidemiological study 446 children were challenged with distilled water. The protocol consisted of 10 minutes tidal inhalation of an ultrasonically nebulized aerosol of distilled water. For children presenting with a clinical diagnosis of asthma the odds ratio for a positive challenge test was 9.1 compared to non-asthmatics [95% confidence intervals: 2.4-34.9; p = 0.001]. Symptoms cough (p = 0.03), cough at night (p = 0.03) and atopy defined by prick-test (p = 0.001) were also significantly associated with a positive challenge. The easy conduct of our protocol, the--from a pathophysiological point of view--"close to asthma" stimulus, and the small number of side-effects, indicate that the challenge with distilled water can be regarded as an alternative to metacholine provocation testing.

Aerosols↗
PubMed1992

[Spontaneous dissection of the internal carotid artery].

A typical case history of spontaneous dissection of the internal carotid artery is presented. In young patients with cerebral ischemia, initial pain in the affected side of the head and neck, a possible provocative mechanism and a transient or even persistent Horner's syndrome are highly suggestive. The angiographic picture of carotid artery dissection is characteristic. Spontaneous resolution is common, and recurrence rare. Surgical treatment can therefore be reserved for individual cases with recurrent ischemia and caused by emboli originating in the dissected segment of the artery.

Aortic Dissection↗
PubMed1992

[Iliac artery and aortic thromboses after percutaneous transluminal angioplasty].

Transluminal angioplasty of iliac arteries is a safe and increasingly used alternative to vascular surgery. Since, especially in this region, life-threatening complications may occur at dilatation site, indication for iliac angioplasty should be examined critically, having due regard to cardiopulmonary disease and prior abdominal procedures which may hamper emergency surgery if required. The technically more difficult catheterisation by contralateral femoral approach involves a higher risk of disseminated cholesterol embolisation due to traumatised and dislodged atheromatous plaques. The report concerns three cases with rapid aortoiliac thrombosis and widespread histologically confirmed cholesterol embolisation in connection with iliac angioplasty.

Aged↗
PubMed1992

Cellular localization of Nef expressed in persistently HIV-1-infected low-producer astrocytes.

OBJECTIVES: The characterization and localization of HIV-1 Nef highly expressed in permanently infected astrocytes (TH4-7-5) as a model for latent infection of human brain cells. DESIGN: Immunochemical methods are an appropriate tool to investigate expression and localization of cellular proteins. METHODS: Nef expression was analysed by Western blot and immunoperoxidase staining using a panel of monoclonal and polyclonal antibodies. Cellular localization studies were performed by indirect immunofluorescence and subcellular fractionation of TH4-7-5 cells. Myristoylation of Nef was investigated by immunoprecipitation of [3H]myristic acid-labelled cell extract. TH4-7-5 nef gene was cloned and amplified by polymerase chain reaction and the nef nucleotide sequence analysed. RESULTS: Reactivities of various Nef-specific antibodies with Nef antigen in TH4-7-5 cells were demonstrated by Western blot analysis. Immunofluorescence revealed cytoplasmic perinuclear staining of Nef with most antibodies. However, one monoclonal antibody against amino acids 168-175 of Nef showed intense homogeneous nuclear staining in TH4-7-5 cells. Reactivity of this Nef antibody was blocked with recombinant Nef derived from TH4-7-5 cells. After subcellular fractionation, Nef was detected in nuclear, membrane and cytosolic fractions of TH4-7-5 cells. No myristoylated Nef antigen was detectable, perhaps because of a serine residue at position 2 of the TH4-7-5 nef gene instead of the glycine residue required for myristoylation. CONCLUSIONS: Chronically HIV-1-infected astrocytoma cells with restricted virus production express different antigenic forms of Nef, which can be distinguished by their subcellular localization. Variant subcellular targeting of Nef suggests the existence of multiple activities of Nef within HIV-infected cells.

Amino Acid Sequence↗
PubMed1992

Molecular cloning of a mink prion protein gene.

Transmissible mink encephalopathy (TME) is a rare disease which is presumably transmitted to ranch-raised mink from scrapie-infected sheep offal or bovine spongiform encephalopathy-infected cattle products. Although the infectious agent of TME has not been isolated, there is circumstantial evidence that TME is caused by prions. The experimental host range of TME includes sheep, cattle, monkeys and hamsters. However, TME has never been transmitted to mice. Since experiments in transgenic animals have shown that the prion protein (PrP) gene modulates the susceptibility, incubation time and neuropathology of prion-induced disease, we have started to analyse the mink PrP gene. PrP, as deduced from a genomic DNA sequence, consists of 257 amino acids and overall shows similarity of 84 to 90% with the sequences of the PrPs of other mammalian species. It remains to be determined whether these differences in the primary structure of PrP will explain the peculiar host range of TME.

Amino Acid Sequence↗
PubMed1992

Effects of antipsychotic drugs on memory functions of schizophrenic patients.

In this research we investigated the effects of 4 antipsychotic drugs with different anticholinergic components on different memory functions of schizophrenic patients. Drugs were administered in cumulative doses and memory was tested 90 min after each drug was administered. The results show that chlorpromazine and thioridazine impaired short-term verbal memory after 6 h of sequential administration. Trifluoperazine and haloperidol improved short-term verbal memory from the third to the fifth administration. Immediate memory, long-term memory and visual short-term memory were not impaired by any drug.

Adult↗
PubMed1992

Determinants of airway response to challenge with distilled water in a population sample of children aged 7 to 10 years old.

We challenged 446 schoolchildren and measured the percent decrease in FEV1 following 10 min of tidal inhalation of UNDW. Assessment tools for respiratory symptoms and atopy were questionnaire and skin testing, respectively. A previous diagnosis of asthma was most strongly associated with a positive airway response (defined as a fall in FEV1 greater than or equal to 10 percent. A positive response was also associated with atopy, presence of cough, cough during night, or any respiratory symptom. A child's age and the prechallenge FEF75% also explained response to distilled water indicating less responsiveness for older children and those with relative greater airway diameter. For the previous diagnosis of asthma, a positive distilled water challenge test had a sensitivity of 36 percent and a specificity of 92 percent. We conclude that a significant relationship between airway response to distilled water, asthma and symptoms suggestive for asthma exists for a childhood population sample.

Asthma↗
PubMed1992

Relationship between dietary components and aspects of sleep.

To test the hypothesis that major dietary constituents are related to quantity or quality of sleep, 27 adult volunteers participated in a five-day study. Subjects completed detailed dietary logs each day, and each morning completed the St. Mary's Hospital Sleep Questionnaire. Dietary data were converted to seven major nutritional constituents and these were averaged over the 5-day period. None of the 98 correlations between diet and sleep were significant. These findings provide no support for a link between sleep and diet in adults.

Adult↗
PubMed1992

Infection of human brain cells by HIV-1: restricted virus production in chronically infected human glial cell lines.

OBJECTIVE: To study expression of HIV-1 in human glial cell lines. DESIGN: Chronically HIV-1-infected glial cell lines were established to evade potential artefacts resulting from unphysiological viral entry (i.e., transfection). These cell lines were used to study viral expression and regulation. METHODS: Chronically infected glial cell lines were established by terminal dilution cloning of human glioma cells exposed to HIV-1. Virus production and expression were assayed by measuring reverse transcriptase activity, p24-antigen levels and syncytia-inducing capacity in C8166 target cells (extracellular), or by indirect immunoperoxidase staining, immunoblot analysis, and p24- and Nef-antigen-capture enzyme-linked immunosorbent assays (intracellular). HIV-long terminal repeat (LTR)-dependent expression of the chloramphenicol acetyltransferase reporter gene was determined in transient transfection assays. RESULTS: Culture supernatant from chronically HIV-1-infected glial cells contained only low levels of virus compared with chronically HIV-infected fibroblasts and T-lymphoma cells. Detailed study of HIV-antigen expression in representative glial cell line TH4-7-5 indicated the presence of all major structural proteins, albeit at low levels, and of Vif, Tat, Rev and Nef. Intracellular levels of Nef exceeded p24-antigen levels by approximately 10-fold. Virus was recovered from TH4-7-5 cells by cocultivation with blood-derived target cells, indicating that low-level virus production is not due to defective provirus. Prominent negative regulatory element (NRE)-mediated suppression of exogenous HIV-LTR activity was observed in TH4-7-5 cells and was unequalled by chronically HIV-producing fibroblast cells or by uninfected fibroblast and glial cells. CONCLUSIONS: Our results suggest that restricted virus production by chronically infected glial cells involves LTR-mediated regulation of virus expression.

Base Sequence↗
PubMed1992

Identification of complex formation between two intracellular tyrosine kinase substrates: human c-Rel and the p105 precursor of p50 NF-kappa B.

Immune complexes of the product of the c-rel protooncogene and of p105, the p50 NF-kappa B precursor, isolated from human T-lymphoblastoid cell lines are comprised of multiple proteins. Only p105 and human c-Rel (hc-Rel) are common to complexes precipitated with antiserum directed against either p105 or hc-Rel. Both proteins are inducible by phytohemagglutinin (PHA) and phorbol 12-myristate 13-acetate (PMA) and their subcellular distribution is affected by this induction. We demonstrate that the Rel immune complex contains a protein with a molecular weight in the 40 kDa range (p40) which apparently is exclusively cytoplasmic. We were not able to detect p40 in the p105 immune complex, though hc-Rel is present. This indicates that hc-Rel exists in different multi-protein complexes and fits a model of functional regulation mediated by differential protein-protein interaction. We also demonstrate considerable isoform diversity of both hc-Rel and p105. We show that this heterogeneity is, in part, the result of phosphorylation. Furthermore, we demonstrate that p105 and hc-Rel are tyrosine kinase substrates. This finding indicates a role for both proteins in intracellular signal transduction pathways which are modulated by modification of their phosphorylation status.

Humans↗